Pitts Laura L, Kanadet Rene M, Hamilton Valerie K, Crimmins Sarah K, Cherney Leora R
Department of Communication Sciences and Disorders, University of Northern Iowa, Cedar Falls.
Department of Physical Medicine & Rehabilitation, Feinberg School of Medicine, Northwestern University, Chicago, IL.
J Speech Lang Hear Res. 2019 Aug 15;62(8):2671-2679. doi: 10.1044/2019_JSLHR-S-18-0366. Epub 2019 Aug 7.
Purpose Dysphagia in Parkinson's disease (PD) is a major cause of depression and reduced quality of life (QOL). PD-related dysphagia often involves lingual dysfunction and weak pressure generation. The relation of disordered lingual pressure generation to swallowing-related QOL in persons with PD remains unknown. Method Twenty-four persons with idiopathic PD completed the Swallowing Quality of Life (SWAL-QOL) questionnaire and an evaluation of anterior and posterior tongue strength. Peak pressures were compared to age- and sex-matched controls. The magnitude of and latency to peak pressure were explored in relation to SWAL-QOL scores. Results Persons with PD exhibited significant anterior (p = .019) but not posterior (p = .081) lingual weakness compared to controls. Persons with PD and reduced anterior tongue strength (< 42 kPa) reported lower SWAL-QOL total (p = .043), extended eating durations (p = .025), and a reduced desire to eat (p = .020). Prolonged latency to peak anterior pressure in PD inversely correlated with SWAL-QOL total (r = -.750, p < .001) and served as a significant, independent predictor of 67% of the variance in SWAL-QOL total when controlling for age, sex, and disease stage. Conclusion Overall, SWAL-QOL scores declined in the presence of lingual pressure dysfunction. Lingual weakness and prolonged pressure building patterns secondary to PD, especially of the anterior tongue, may represent clinically relevant disruptions to mealtime behaviors that undermine swallowing-related QOL. These preliminary findings support further investigation of lingual pressure patterns in PD to help identify debilitating dysphagia and develop treatment strategies.
目的 帕金森病（PD）中的吞咽困难是导致抑郁和生活质量（QOL）下降的主要原因。与PD相关的吞咽困难通常涉及舌功能障碍和压力产生减弱。PD患者舌压力产生紊乱与吞咽相关生活质量之间的关系尚不清楚。方法 24名特发性PD患者完成了吞咽生活质量（SWAL-QOL）问卷以及舌前和舌后力量评估。将峰值压力与年龄和性别匹配的对照组进行比较。探讨峰值压力的大小和延迟与SWAL-QOL评分的关系。结果 与对照组相比，PD患者表现出显著的舌前肌无力（p = .019），但舌后肌无力不显著（p = .081）。舌前力量降低（< 42 kPa）的PD患者报告的SWAL-QOL总分较低（p = .043）、进食时间延长（p = .025）和进食欲望降低（p = .020）。PD患者舌前压力峰值延迟延长与SWAL-QOL总分呈负相关（r = -.750，p < .001），并且在控制年龄、性别和疾病阶段时，是SWAL-QOL总分67%方差的显著独立预测因子。结论 总体而言，在存在舌压力功能障碍的情况下，SWAL-QOL评分下降。PD继发的舌肌无力和压力形成模式延长，尤其是舌前部，可能代表对进餐行为的临床相关干扰，从而损害吞咽相关生活质量。这些初步发现支持进一步研究PD中的舌压力模式，以帮助识别使人衰弱的吞咽困难并制定治疗策略。
